Multiple myeloma is a bone marrow disease characterized by the presence of malignant plasma cells, & abnormal serum &/or urine immunoglobulin secondary to clonal plasma cell expansion.

It accounts for 1-2% of all cancers worldwide & mostly affects patients at ages 65-74 years old.

Patient usually presents with bone pain & nonspecific symptoms, or due to abnormalities in laboratory exams.


Differential Diagnosis

  • Other plasma cell proliferative disorders
    • Include other plasma cell proliferative disorders that do not meet the criteria for multiple myeloma but may eventually progress into multiple myeloma
    • Solitary (Isolated) Plasmacytoma
      • Diagnostic criteria should include all of the following: Biopsy-confirmed solitary bone or soft tissue lesion w/ evidence of clonal plasma cells, normal bone marrow without any evidence of clonal plasma cells, normal skeletal survey & no abnormalities in CT & MRI except for a primary solitary lesion, & no evidence of end-organ damage (CRAB criteria) attributable to any plasma cell proliferative disorder
      • May progress into multiple myeloma (10% progression rate in 3 years)
    • Extramedullary plasmacytoma
    • Osteosclerotic myeloma (POEMS syndrome)
    • Waldenström macroglobulinemia
  • Light chain amyloidosis
  • Plasma cell leukemia
  • Heavy chain disease
  • Bone metastasis
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